After spending most of yesterday in recovery from a near-sleepless night at the EMS, I logged on to Twitter today and noticed an interesting tweet from Chris Kaiser (@ckemtp on Twitter – an all around good fellow and follow, by the way). It was a link to an article about apathy in EMS. The article, entitled “Apathy in EMS is Pathetic” asks some hard questions that all of us in EMS should be asking ourselves: “Do EMS providers really care about EMS, or is it just a temporary job until something better comes along? Is it just a young person’s game? Do EMS providers really care about the profession as a whole and worry about its future?” Often I wonder the same things that Dr. Bledsoe asks in his article. Why do so many EMS people seem to apathetic when it comes to their field?

When it comes to people in my area, I can’t help but think that a lot of them don’t speak up more for positive changes because “it’s just the way it is and the way it always has been.” Evidently they’re not alone. A survey conducted by JEMS indicates that, despite safety concerns, the average EMS shift in the cities surveyed in their 200 City Survey remains at 24 hours and a lot of that seems to stem from tradition. Could you imagine what EMS would be like if we kept our protocols the same just out of tradition (and, to a degree, I’d speculate that some do). Accepting the status quo is not always in the best interests of ourselves and certainly not in the best interests of our patients. However, many of us do and a lot of that is because of the “it’s just always been that way” mentality.

I don’t know about you but I’m all for bucking tradition (whenever and however possible).

I wrote about EMS 2.0 in my last post and it’s very much inclusive of some of the issues that possibly lead to EMS apathy. One think CK and I discussed earlier was the need to have better pay for EMS crewmembers and treatment that actually makes a difference. I agree 100%. Part of the overhaul of EMS will be addressing the factors that make EMTs and medics want to jump ship. I know of several people who are working in EMS and in school for areas of study that have little, if anything, to do with EMS. A lot of people see EMS as a stepping stone or as a means to collect a check while they’re in school. If that’s what they want, that’s fine. I’m not going to fault them if it’s really what they want. However, I think we have too many people with that mentality and we need to do all we can to reduce those who will let their licenses lapse after they graduate from school. We need to increase the number of people who truly care about EMS, its future, about making it better and, just as important, who are in it for long-haul. We need people whose long term career plans are to stay in EMS for as long as they possibly can, be it on the front lines or in EMS education.

The pay thing is an important factor to address as well. The last salary survey that JEMS performed is very telling. Did you know that even within EMS itself there are big salary discrepancies? The average EMT makes just over $28,000 and the average medic makes about $38,000 (the medic making more is understandable since they have more education than a Basic). However, if you continue on to support staff, an IT manager makes about $68,000. Wow. Now, I’m not downplaying the training and long hours that IT people put in and they are very important to what we do. However, I don’t like the huge gap in pay between those on the front line and someone who essentially works behind the scenes. Those who are directly responsible for patient care should be paid better than they are. Remember, these numbers are averages and many don’t make as much as the survey claims is the median. Especially in settings like mine, a medic may not make even over $30,000 a year. The lower pay is a slap in the face of those who are on the front line and who work long hours and spend so much time away from their families, compared to others who make more and work 9-5 Monday-Friday.

Changes will happen but it will take time. It took nurses decades to get the respect and pay they have. However, they earned their respect and higher pay. Simply put, they insisted on more education and more accountability in their profession. They demanded that they be allowed to give better patient care overall and they proved that they deserve what they’ve achieved. I’m not saying that us in EMS haven’t earned respect but we, as a profession, haven’t done enough in the areas of education and accountability. EMS 2.0 is a great step in the right direction but implementing it is going to take some doing. We have to make it attractive to the decision makers in order to truly make this successful. We can push for it all we want but we have to get our higher-ups on board in order to make it happen. That’s where we take pages from nursing’s playbook and act accordingly.

What do you think can be done in order to combat apathy within EMS? What can we do to improve our working conditions, pay and our ability to care for our patients? How can we make EMS a legitimate career and profession rather than a stepping stone to something else? Please feel free to leave your thoughts as a comment or you can email them to me (you can leave your name off if you wish). I may use the ideas in another post in the future.